Saturday, July 4, 2009

Ankle Pain - Not What You Think!

Most people associate ankle pain with an ankle sprain - pain at the outside of the ankle. But does anyone ever experience pain along the inside of the ankle?

Gradual or occasional pain behind the ankle bone on the inside of the ankle could be the start of a serious problem with the tendon that supports the arch. Many women, as they enter their 40's, begin to have excessive pressure on the posterior tibialis tendon, the strong tendon that helps hold up the arch.

Extra weight, increased activities, flat feet, and shoes with a lack of arch support all contribute to this problem. If untreated and allowed to progress, the tendon can become inflammed, tear and even rupture. This is one condition that pays to treat it early on!

Treatment differs depending on the stage of progression it is in, but will always include reducing the stress on the tendon. Pain or discomfort may be present but one common sign is that your arch seems to have "fallen."

I should know! Not only do I treat Posterior Tibial Tendon Dysfunction (PTTD), but I have started to show signs of it as well!!


  1. This is a very common disorder among women in their 40's and 50's. We see patients like that almost on a daily basis. Great article!

  2. Hi Dr. Reid,
    How often do you treat PTTD with surgical intervention? I have noticed that many people especially women in their 40's and 50's are not ready to have surgical correction. They would rather deal with the pain than go through surgery and have to stay off their feet for a long period of time. How do you convince a busy 40/50 yr old mom that she needs surgery when it does have to come to that?
    Sharon Joag

  3. HI Sharon,

    Surgery is really not that big of a deal. It doesn't mean that you would be off your feet for weeks and weeks like it meant years ago.

    It really depends on what stage your PTTD is at. Like anything else, it is best treated (even surgically) if it is treated early on. What is important to remember is that foot problems are progressive and as they worsen, the are more difficult to treat - conservatively as well as surgically.

    It is so much better to address problems early on - women in their 40's and 50's make up 80% of my praactice!

  4. Dr. Reid!
    That's excellent! Thank You. I have not had as easy a time convincing people that they need surgery in my practice.
    I'll have to pick your brain a little...
    But no matter what I say, most of the women I see do not want to stay off their feet. They would rather deal with the pain...and use a brace.
    Thanks for your article. :)
    Sharon Joag